Bilirubin Test - Jaundice - HealthSurgeon - Healthy Living and Fitness

When your red blood cells are broken down your body makes bilirubin. Your liver processes the bilirubin and then it is processed with the other waste in your body. Bilirubin travels through your liver, gallbladder, and digestive tract. Bilirubin is what gives your bile the yellow color, and it also colors your poop. High and low levels of bilirubin can be signs for other underlying conditions.

Symptoms

The main sign of high bilirubin levels is jaundice. Jaundice is the yellowing of your skin and eyes. Other symptoms that coincide with high levels of bilirubin are dark urine, nausea, vomiting, abdominal pain, abdominal swelling, fatigue, chills, fever, chest pain, and lightheadedness.

Causes

High levels of bilirubin can be caused by a number of things. If you are showing signs of jaundice or have one of the symptoms that are associated it is a good idea to get tested. A bilirubin test is done with a blood sample. For newborns it is done with a heel stick. Other reasons you should test are if you have a history of heavy drinking, you have been exposed to a hepatitis virus, or you have cirrhosis. A bilirubin test can help diagnose or monitor liver and bile duct diseases such as cirrhosis, hepatitis, and gallstones. It can help investigate jaundice, which is common in newborns. Testing can also check to see if levels are decreasing or rising over time. Testing can evaluate anemia. It can also be a follow up to check if treatment is working.

Diagnosis

Results of a bilirubin test can come back as direct, indirect, or total. Direct results are from bilirubin once it reaches the liver. Indirect are results from bilirubin from red blood cell breakdown, and it traveling in your bloodstream. High levels of direct bilirubin may indicate liver damage or liver disease. High levels of indirect bilirubin can be a sign of other problems.

High levels occur when bilirubin builds up in your blood. You may be over producing bilirubin if your body breaks down too many red blood cells too fast. Another cause of high levels is if the liver is having trouble processing your normal levels of bilirubin. There may also be a blockage in your bile ducts which can lead to a build up as well.

Causes of high levels of bilirubin are anemia, cirrhosis, a reaction from a blood transfusion, Gilbert syndrome, viral hepatitis, a reaction to medications, alcoholic liver disease, gallstones, or strenuous exercise.

Low levels of bilirubin are less common and usually no reason for concern. Low levels are usually left alone since they aren’t as concerning. Medications can cause low levels of bilirubin such as antibiotics, birth control pills, sleeping pills, or seizure medications.

Treatment

Treatment for high levels of bilirubin are dependent on the cause. Usually treating and managing the underlying cause can help levels come back down. Leaving levels of bilirubin too high can be toxic. Eliminating alcohol and medications even over the counter ones can be beneficial in lowering bilirubin levels. It is also important to maintain a healthy diet. Once a treatment plan has been established levels should start to decline. Your doctor may want to do a few more bilirubin tests to make sure levels are decreasing and treatment is working.

Risk Factors

Newborn jaundice is very common. Bilirubin levels in newborns are usually checked within the first few days of life. Jaundice is usually present between day one and day 3 after a baby is born. Levels usually lower by themselves without any treatment needed. Feeding your baby 8-12 times per day helps your baby have more bowel movements which gets rid of the bilirubin in your body. If levels don’t come down on their own, or they continue to rise your doctor may want to intervene with some treatment. Treatments can include phototherapy, which is the most common, IV immunoglobulin treatment, or an exchange transfusion. High levels in newborns can be caused by a blood type incompatibility between mother and baby, lack of oxygen, an inherited infection, or a disease that affects the liver.

Takeaway

High bilirubin levels are usually not life threatening, but it is important to get them treated and managed. In newborns too high of bilirubin levels can be toxic. High levels of bilirubin in newborns usually resolve on their own without treatment. If levels do not decrease or continue to rise, intervention with some treatment may be necessary. High bilirubin levels in adults usually indicate something is not working correctly, whether that is your liver, gallbladder, or digestive tract. Testing your bilirubin levels can help identify what is causing the buildup which can help with treatment and management.